{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T15:27:49Z","timestamp":1790263669707,"version":"4.1.0"},"reference-count":39,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2022,11,11]],"date-time":"2022-11-11T00:00:00Z","timestamp":1668124800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Aims<\/jats:title><jats:p>Hypercholesterolemia is frequent in people with primary biliary cholangitis (PBC); however, it does not seem to confer an increased risk of cardiovascular disease. We aimed to evaluate the prevalence of peripheral arterial disease in PBC women and its association with the gut\u2013liver axis and systemic inflammation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Thirty patients affected by PBC and hypercholesterolemia were enrolled, with equal\u2010sized groups of women with non\u2010alcoholic fatty liver disease (NAFLD) and healthy controls (CTRL). All patients underwent Doppler ultrasound examination of peripheral arteries, assessment of flow\u2010mediated dilation, quantification of circulating cytokines and vasoactive mediators and characterization of the gut microbiota.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>PBC patients had a higher prevalence of lower extremity arterial disease (LEAD) defined as atherosclerotic plaques in any of femoral, popliteal and\/or tibial arteries compared with both NAFLD and CTRL women (83.3% vs. 53.3% and 50%, respectively; <jats:italic>p<\/jats:italic>\u00a0=\u2009.01). Factors associated with LEAD at univariate analysis were VCAM\u20101 (<jats:italic>p<\/jats:italic>\u00a0=\u2009.002), ICAM\u20101 (<jats:italic>p<\/jats:italic>\u00a0=\u2009.003), and TNF\u2010alpha (<jats:italic>p<\/jats:italic>\u00a0=\u2009.04) serum levels, but only VCAM\u20101 (OR 1.1, 95% CI 1.0\u20131.1; <jats:italic>p<\/jats:italic>\u00a0=\u2009.04) and TNF\u2010alpha (OR 1.12, 95% CI 0.99\u20131.26; <jats:italic>p<\/jats:italic>\u00a0=\u2009.04) were confirmed as independent predictors in the multivariate model. Gut microbiota analysis revealed that <jats:italic>Acidaminococcus<\/jats:italic> (FDR\u00a0=\u00a00.0008), <jats:italic>Bifidobacterium<\/jats:italic> (FDR\u00a0=\u00a00.001) and <jats:italic>Oscillospira<\/jats:italic> (FDR\u00a0=\u00a00.03) were differentially expressed among groups. <jats:italic>Acidaminococcus<\/jats:italic>, which was increased in PBC, was positively correlated with TNF\u2010alpha serum levels. Down\u2010regulation of metabolic pathways linked to fatty acid and butyrate metabolism, glyoxylate metabolism and branched\u2010chain amino acids degradation was found in the functional gut metagenome of PBC women.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>LEAD is common in patients affected by PBC and is associated with inflammatory markers and alterations in the gut\u2013liver axis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/liv.15463","type":"journal-article","created":{"date-parts":[[2022,10,26]],"date-time":"2022-10-26T14:21:26Z","timestamp":1666794086000},"page":"370-380","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["High prevalence of lower limb atherosclerosis is linked with the <scp>gut\u2013liver axis<\/scp> in patients with primary biliary cholangitis"],"prefix":"10.1111","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5924-6238","authenticated-orcid":false,"given":"Francesca Romana","family":"Ponziani","sequence":"first","affiliation":[{"name":"Internal Medicine and Gastroenterology\u2013Hepatology Unit Fondazione Policlinico Universitario Agostino Gemelli IRCCS  Rome Italy"},{"name":"Department of Cardiovascular Sciences, Angiology and Noninvasive Vascular Diagnostics Unit Fondazione Policlinico Universitario Agostino Gemelli IRCCS  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Nesci","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, Neuroscience and Orthopedics Fondazione Policlinico Universitario Agostino Gemelli IRCCS  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camilla","family":"Caputo","sequence":"additional","affiliation":[{"name":"Internal Medicine and Gastroenterology\u2013Hepatology Unit Fondazione Policlinico Universitario Agostino Gemelli IRCCS  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucia","family":"Salvatore","sequence":"additional","affiliation":[{"name":"Internal Medicine and Gastroenterology\u2013Hepatology Unit Fondazione Policlinico Universitario Agostino Gemelli IRCCS  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Picca","sequence":"additional","affiliation":[{"name":"Multimodal Laboratory Medicine Research Area Unit of Human Microbiome, Bambino Ges\u00f9 Children's Hospital IRCCS  Rome Italy"},{"name":"Department of Medicine and Surgery LUM University  Casamassima Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federica","family":"Del Chierico","sequence":"additional","affiliation":[{"name":"Phase 1 Unit Fondazione Policlinico Universitario Agostino Gemelli IRCCS  Rome 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